Two years after integrating an electronic medical records system into Jefferson Street Family Practice, Dr. Ajay Gupta and his colleagues are reaping the benefits, especially in work flow.

“It’s shifted responsibilities, and frees us up to direct more time toward patient care,” Gupta said. “As we’ve gotten busier, we haven’t had to add more staff.”

Gupta said he and his colleagues still debate internally whether it’s helping the practice’s bottom line, but the improvements in work flow and e-prescribing capability and the creation of a patient portal have been well worth the effort. Also, the office is now positioned to take advantage of federal financial incentives being offered through Medicare and Medicaid. The incentives will take effect in 2011. For physicians who fail to adopt health information technology, or HIT, Medicare payments will be cut.

Even with these incentives, Gupta said the decision to buy an electronic health record system wasn’t easy. The group interviewed more than six vendors — via online sales presentations — and even served as a testing site for a startup technology firm.

“We wanted to find and make sure that the company would be there. Otherwise, we would be putting in a lot of time integrating a system, and then a company would either be sold or go bankrupt, and we’d be starting over,” Dr. Gupta said.

For doctors and small practices just starting the long process of adopting HIT, concerns about cost, time and meeting federal guidelines for usability and interoperability with a health information exchange are making it difficult.

Now, with federal incentives and the opening of HIT Regional Extension Centers in Texas, the adoption of electronic medical record, or EMR, technology should be gaining momentum, experts said. Texas has four regional extension centers aimed at helping doctors and rural hospitals choose and implement EMR systems.

Once fully implemented, EMRs will greatly improve patient care, many say. When used effectively, they will reduce medical errors and duplication of tests. A patient’s medical history will follow him or her from the doctor’s office to the hospital, helping medical professionals make informed decisions.

In the long run, it also makes financial sense, according to one study.

“Adopting an electronic system can be costly and time-consuming, and understanding the impact it will have on the practice is critical,” William Jessee, president and CEO of MGMA, said in a release. “These data indicate that there are financial benefits to practices that implement an [electronic health record] system.”

Joseph Schneider, the chief medical information officer and medical director for Baylor Health Care System, said he’s seeing physicians on both sides of the fence.

“Some of our physicians are ready to do this and some aren’t. Certainly, the incentives have raised the interest level of physicians,” Schneider said.

Among the chief concerns is the time it would take a physician to interview HIT vendors and learn a new system, which depends largely on how comfortable a physician or administrator is with technology.

Once a practice chooses a system, it takes time to get the doctors accustomed to typing what they would have typically written. In most cases, doctors need to cut their patient load until they become more adept at using the system, thereby affecting revenue.

EMRs can have varying levels of complexity, depending on the type of practice. And many doctors believe the technology that’s available isn’t intuitive enough to make medical transcription quick.

While for a patient with a cold, for instance, a doctor could document symptoms using a template, inputting information on a patient with heart disease or diabetes is more complex.

“There is fear and concern, and at the top of these is that [the technology] isn’t as easy or as good as it needs to be,” Schneider said.

Nevertheless, Schneider believes the creation of the regional extension centers will be a big help in preparing some smaller practices and rural hospitals for HIT. And the Texas Medical Association and Texas Academy of Family Doctors have positioned themselves as go-to resources for doctors looking for guidance.

David Fleeger, of Central Texas Colon and Rectal Surgeons, said his practice spent a good deal of time interviewing vendors before choosing an EMR vendor.

“We wanted to make sure our questions were answered and make sure that we were meeting the meaningful use criteria,” Fleeger said.

For the majority, investing in health information technology is the right thing to do, but for a small minority, such as physicians retiring soon, it doesn’t make sense, he said.

Often, the biggest hurdle for a physician or administrator making these decisions is information.

“Are you and your practice aware enough of what EMRs do and how they do it?” Schneider said.

Not understanding EMR before you take the plunge could have negative consequences, especially for a single or small practitioner, Schneider said.